Answer

Dear Curious,

To begin this discussion about AIDS, or acquired immune deficiency syndrome, it’s helpful to first understand the virus that is associated with it. HIV (human immunodeficiency virus) infects certain types of white blood cells, mainly CD4 cells (also called helper cells or T cells), which are a part of the immune system that protect against infection. The virus damages the immune system and leaves individuals vulnerable to otherwise harmless infections and certain other diseases. AIDS is a result of the progression of HIV in the body. The criteria for an AIDS diagnosis includes an HIV positive person’s CD4 count dropping below a certain level or having developed a certain type of infection that more often occurs in those with severely weakened immune systems, which are referred to as opportunistic infections (OIs) (to read more about the specifics on the AIDS diagnosis, check out What is AIDS?[2] in the Go Ask Alice! archives). Treatment can be useful in delaying the progression from HIV to AIDS, allowing individuals to live longer, healthier lives. However, without treatment, HIV may continue to weaken the immune system.

When you talk about the “situations” in which people suffer from AIDS, if you mean certain health conditions, it may be more clearly explained by OIs. What’s critical to know about an AIDS diagnosis is that if a person infected with HIV develops an OI, regardless of her/his CD4 count, they will likely receive a diagnosis of AIDS. Some OIs might sound familiar because many of these infections are caused by pathogens that healthy individuals may have without becoming ill. Others are rare and are only typically seen in or are associated specifically with those who have severely compromised immune systems. Some infections that are commonly identified as OIs include:

Herpes simplex virus: This virus (commonly sexually transmitted) is often latent or inactive in healthy individuals. However, in those with compromised immune systems, outbreaks and symptoms are more likely to recur.

Candidiasis (yeast infections): Folks who are HIV positive are more likely to have trouble controlling the growth of yeast in the mouth and in the vagina. But, this uncontrolled overgrowth of yeast in the body is only considered an OI if affects certain parts of the body, including the esophagus, trachea, and deep lung tissues.

Pneumonia[3]: This condition is characterized by an inflammation of the lungs due to infection and can be recurring in individuals with HIV. One common cause of pneumonia, known as bacteria Streptococcus pneumoniae, or Pneumococcus, can be life-threatening for those with HIV/AIDS. Vaccines are advised for HIV patients to prevent this type of infection.

Lymphoma (cancer of the lymph nodes): Both Hodgkin’s and non-Hodgkin’s forms of lymphoma are associated with HIV.

Kaposi’s sarcoma (KS)[5]: a rare form of skin cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, throat, or in other organs. KS usually develops slowly, though it moves quicker in HIV/AIDS patients.

Wasting syndrome: This is a condition specifically associated with HIV, in which a person can involuntarily (without trying) lose approximately ten percent of their body weight while also experiencing diarrhea and vomiting over about a month’s time.

The good news is that OIs in general are less common now than they were when HIV and AIDS first hit the scene. This is due, in part, to enhanced, immune system-strengthening treatments. Despite this advancement, some HIV positive folks may still develop them due to being unaware of their HIV positive status. It might also be the case that a person’s susceptibility is increased because they are either not currently undergoing treatment or the treatment that they are receiving is not adequate enough to suppress the virus in their bodies, so that their immune systems may fight off infections.

Though HIV and AIDS are related, only a health care provider can diagnose an individual with AIDS. The good news is a healthy lifestyle, paired with antiretroviral medicines, and consistent medical care may help an infected individual add more years to their life and life to their years. Further, treatments are available for folks who do come down with an OI. Still Curious? Then consider doing a little digging in the HIV/AIDS category in the Go Ask Alice! archives, which is chock-full of information and resources.